Learn about the causes, risk factors and complications of gestational diabetes, as well as how to protect maternal health and ensure a healthy pregnancy.

Key Takeaways:

• Gestational diabetes is a form of diabetes that develops in pregnant women, usually between 24 and 28 weeks of gestation.
• The condition arises due to increased insulin resistance during pregnancy, caused by hormones from the placenta.
• Certain risk factors increase the likelihood of gestational diabetes, including obesity, high blood pressure, heart disease, PCOS, family history of diabetes, previous gestational diabetes and physical inactivity.
• Untreated gestational diabetes can lead to complications such as premature birth, excessive birth weight, stillbirth, excessive bleeding in the mother and depression.
• Prevention strategies include regular exercise, a healthy diet, and maintaining an appropriate weight for a healthy pregnancy.

Gestational diabetes is a condition in which pregnant women who were not previously diagnosed with diabetes develop high blood sugar levels. It typically occurs between the 24th and 28th weeks of pregnancy. According to the Australian Institute of Health and Welfare, the prevalence of gestational diabetes in Australia has risen from 5% to 17.9% between 2000-01 and 2021-22.

The incidence of gestational diabetes varies significantly by age, ethnicity, socioeconomic background and lifestyle habits:

• Age: Gestational diabetes is more common in older pregnant women. Research shows that the incidence increases with maternal age, affecting around 11% of women under 25 years, 33% of women aged 25-34 years and 27.7% of women over 40 years old.
• Ethnicity: Certain ethnic groups are at higher risk of gestational diabetes. Women of South Asian, African, Pacific Islander, Hispanic and Native American descent are more likely to develop gestational diabetes than those of Caucasian descent. In Australia, Indigenous women are twice as likely to be diagnosed with gestational diabetes as non-Indigenous women.
• Socioeconomic background: Socioeconomic factors can influence the risk of gestational diabetes. Women from lower socioeconomic backgrounds may have limited access to healthy food, physical activity opportunities and healthcare services. In Australia, women living in more socioeconomically disadvantaged areas are 33% more likely to develop gestational diabetes than those in the least disadvantaged areas.
• Lifestyle habits: Unhealthy lifestyle habits, such as poor nutrition and physical inactivity, can increase the risk of gestational diabetes. Pregnant women with excessive weight gain, high consumption of sugary and processed foods and low physical activity levels have a higher risk of developing gestational diabetes

Gestational diabetes can have adverse effects on both the mother and the baby. Pregnant women should be tested for gestational diabetes between the 24th and 28th weeks of gestation, particularly those with risk factors.

Causes of gestational diabetes

During pregnancy, the placenta produces hormones that support the baby's growth and development. These hormones also interfere with insulin action, leading to insulin resistance.

Insulin resistance increases the body's demand for insulin, and if the body cannot meet this demand, blood glucose levels rise, resulting in gestational diabetes. This condition usually resolves within the first six weeks postpartum, but it increases the risk of developing type 2 diabetes later in life.

Who is at higher risk of gestational diabetes?

While any woman can potentially develop gestational diabetes during her pregnancy, some women are more susceptible to it due to certain risk factors, including:

• Excess weight or obesity
• High blood pressure
• Heart disease
• Polycystic ovary syndrome (PCOS)
• Family history of diabetes
• Previous gestational diabetes or having delivered an overweight baby
• Lack of physical activity
• Age over 25
• Ethnic background (higher risk in South Asian, African, Pacific Islander, Hispanic and Native American women)

Complications of gestational diabetes

Gestational diabetes is a serious condition that can have significant consequences for both mother and baby if left unmanaged. Though it often doesn't cause noticeable symptoms, certain warning signs of gestational diabetes can indicate elevated blood glucose levels. These include excessive thirst, frequent urination, fatigue and blurred vision.

It is essential to note that some women with gestational diabetes may not experience any noticeable symptoms, which is why regular prenatal check-ups and screening tests are crucial.

The complications of gestational diabetes can be wide-ranging and impact both the immediate and long-term health of the mother and the baby. Proper diagnosis and management of gestational diabetes are vital to preventing these complications and ensuring a healthy pregnancy and postpartum period. Below are some of the potential complications of uncontrolled gestational diabetes.

Premature birth

Gestational diabetes can increase the risk of delivering the baby before the full term, which can lead to various health issues for the newborn.

Excessive birth weight

High blood glucose levels in the mother can lead to excessive growth in the baby, resulting in a condition called macrosomia. This can make delivery more challenging and increase the risk of birth injuries.

Stillbirth

Uncontrolled gestational diabetes may increase the risk of stillbirth, where the baby is born without any signs of life.

Excessive bleeding in the mother

Gestational diabetes can increase the risk of excessive bleeding during childbirth, which may pose risks to both mother and baby.

Depression during pregnancy

Women with gestational diabetes may be more likely to experience depression during pregnancy, which can have adverse effects on their physical and mental health.

Low blood sugar levels in the baby

Babies born to mothers with gestational diabetes may have low blood sugar levels after birth, which can cause seizures and other health issues.

Jaundice

Newborns of mothers with gestational diabetes may be more likely to develop jaundice, a condition that causes yellowing of the skin and eyes due to excess bilirubin in the blood.

Risk of developing type 2 diabetes

Both the mother and the baby have an increased risk of developing type 2 diabetes later in life.

Higher weight later in life

Babies born to mothers with gestational diabetes have an increased risk of developing obesity later in life.

Preventing gestational diabetes

To lower your risk of developing gestational diabetes, consider the following strategies:

• Regular exercise: Engage in physical activity to improve insulin sensitivity and manage weight.
• Healthy diet: Consume a balanced diet high in fibre and essential fatty acids, and low in sugar.
• Maintain a healthy weight: Discuss with your doctor the appropriate weight for a healthy pregnancy.
• Monitor blood sugar levels: If you have gestational diabetes, monitor your blood sugar levels at home using a glucose metre or continuous glucose monitor.
• Consult your healthcare team: Talk to your healthcare team about managing your blood sugar levels, preventing gestational diabetes and ensuring a healthy pregnancy.

Vively is a metabolic health app that can help you track your blood glucose levels, identify triggers and implement strategies to improve glucose control. Consult your healthcare team about using Vively as part of your gestational diabetes management plan.